MEDICARE: EAGLE CREEK HEALTHCARE GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	1758N	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558392100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE CREEK HEALTHCARE GROUP, INC.

Provider Business Mailing Address
First Line	:	23700 COMMERCE PARK
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5827
Country	:	US
Telephone Number	:	216-292-5706
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 SPRUCE LN
Second Line	:
City	:	WEST UNION
State	:	OH
Zip	:	45693-8807
Country	:	US
Telephone Number	:	937-544-5531
Fax Number	:	937-544-3478

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM I. WEISBERG
Credential	:	NHA
Telephone Number	:	216-292-5706

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	01/10/2022

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1053720532 — DANETA COLVIN LPTA
Practice Location Address:

141 SPRUCE LN
WEST UNION, OH
45693-8807

Practice Phone: 937-544-5531
Practice Fax:

1184445009 — ALEXIS PHIPPS
Practice Location Address:

141 SPRUCE LN
WEST UNION, OH
45693-8807

Practice Phone: 937-544-5531
Practice Fax:

1295232437 — MIRANDA BETH MELQUIST LSW
Practice Location Address:

11924 ARBUCKLE RD
UNION CITY, PA
16438-8807

Practice Phone: 814-460-8135
Practice Fax:

1003613571 — ANTHONY SHRECK
Practice Location Address:

114 LAKE SIDE TRL
UNION, OH
45322-8807

Practice Phone: 937-673-2680
Practice Fax:

1679896096 — SHERYL SUGRUE SMITH
Practice Location Address:

344 DAVIES AVE
WEST HENRIETTA, NY
14586-8807

Practice Phone: 585-444-0195
Practice Fax: 585-368-4815

Directions to “EAGLE CREEK HEALTHCARE GROUP, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.